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NEUROLOGISTS AND THEIR AVOCATIONS

INTEGRATING WORK, HOME AND PLAY

Avitzur, Orly, MD, MBA

IN PRACTICE

For particularly fortunate neurologists, avocations and passions complement medical practice to create harmony in their daily lives. Whether an intentional quest or the result of serendipity, those who have managed to find the right balance describe themselves as more fulfilled in the workplace.

For the first of this two-part article, Neurology Today spoke with neurologist musicians, artists, writers, and others who discovered a way to integrate their non-medical talents and interests with their day-to-day practice and, often, with family life as well.

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MICHAEL E. CHARNESS: A FAMILY QUINTET

Michael E. Charness, MD, Chief of Staff at the VA Boston Healthcare System, knew that few spouses would tolerate his devotion to musical practice when he returned home after a 15-hour work-day. So when he was set up with a professional flutist on a blind date after the 1982 AAN Annual Meeting, he proposed to her within hours. He and his wife, Deborah, soon began to give recitals together. They started each of their three children in musical studies at the age of four, and the Charness Family Quintet, who have their own Web site, www.charnessfamily.net, now practices together evenings and performs nearly every other Sunday.

Although his primary research has focused on the effects of alcohol on the nervous system, Dr. Charness first became interested in neuromuscular problems in musicians 20 years ago when he developed a subtle hand problem that interfered with his performance and seemed to stump clinicians. His temporary difficulties, eventually resolved by successful ulnar nerve release, became the seed of a growing fascination with the then nascent field of performing arts medicine.

He was soon seeing a growing stream of musicians in the back of his laboratory – then at the University of California-San Francisco – where he provided them with free consultations. “I had no experience in the area, but learned as I went along,” he said. When he moved to Boston in 1989, he got his first real clinic, which later evolved into the Performing Arts Clinic at the Brigham and Women's Hospital. He now serves as its Director.

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RICHARD J. LEDERMAN: FOCUS ON INSTRUMENTALISTS

Richard J. Lederman, MD, PhD, Professor of Medicine at the Cleveland Clinic Lerner College of Medicine of Case Western University, has been playing the violin and performing in chamber music groups for over 50 years.

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“I began seeing instrumentalists in the late 1970s, at the request of the President of the Cleveland Institute of Music, while I was taking lessons from him there,” he said. “At the time there was virtually nothing available in the medical literature on the subject of playing-related problems in instrumentalists. It gradually became clear to me, however, that there were medical conditions that many of these performers had in common.”

In the mid 1980s, Dr. Lederman and colleagues in rheumatology and orthopedics set up a clinic for instrumentalists, which has been in existence ever since. He met Alice Brandfonbrener, MD, in 1983 when he attended her conference on medical problems of musicians, and formed a collaboration that continues today. They jointly sponsor the conference and have authored two editions of a textbook on the subject. Over time, Dr. Lederman has seen over 1,500 instrumentalists for various disorders including muscular pain syndromes, nerve entrapments, and focal dystonias.

“I still love neurology and appreciate the rewards that come from patient care, but there are aspects of clinical practice that have become drudgery,” he said. “When I play the violin, I am transported…everything else disappears.”

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LUD GUTMANN: SOLACE IN WRITING

Ludwig (Lud) Gutmann, MD, finds himself absorbed by another type of creative process. The Hazel Ruby McQuain Professor of Neurology at West Virginia University, and its former Chair of Neurology for 28 years, has been writing short stories for the past four years. He has published several including a recent entry in Nisus Personal History in Neurology entitled “The Pipes of Pan.” (Another story, “The Tattoo,” will appear soon.)

“Although the tales are mostly about patients, I emphasize their human qualities, rather than their diseases,” he explained. “Writing is a special way to express ideas. It allows me to describe my patients and the drama of dealing with the challenges of life. Scientific writing misses those aspects. People are often much more interesting than their diseases.”

Dr. Gutmann, an avid jogger, said, “Running is a quiet time when thoughts seem to flow freely and sometimes on their own. It is a time when concepts evolve. The idea of axonal channelopathies, which resulted in a lead review in Neurology some years ago, occurred to me during a run, as have some of my stories. I can go miles without recalling what I have passed because I am so engrossed in thoughts and ideas.” His wife, Mary, a writer and former editor, was initially his tutor in creative writing; she is now his editor and advisor.

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ARTHUR H. GINSBERG: POETRY INSPIRED BY NEUROLOGY

Arthur H. Ginsberg, MD, a neurologist who has been in practice in Seattle for the past thirty years and is a published poet, also finds inspiration from neurology. Dr. Ginsberg, who wrote “Locked-In Syndrome” for a recent Nisus entry and whose work appears regularly in the anthology Blood and Bone from University of Iowa Press, published his first book of poetry, Walking the Panther (Northwoods Press), in 1984.

“Events from my practice often trigger poems,” he said. “Writing provides me with a way to deal with the emotional and non-technical aspects of illness and to address the human elements. Poetry has broadened my perspective of medicine and helped me maintain the essential connection between physician and patient.”

He added: “I don't feel fulfilled unless I write on a regular basis.”

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R. ALLISON RYAN: PHOTOGRAPHY AS A PASSION

R. Allison Ryan, MD, PhD, a neurologist in practice in Northampton, MA, and a photographer, has always been interested in brain processing of imaging and, in fact, did her PhD research on the neurophysiology of visual perception. She began to display her work professionally four years ago after winning second place in a photography contest. Dr. Ryan incorporates photography into her other passions which include sports and travel.

Dr. Ryan describes her waiting room as one in which patients don't mind waiting. It is wallpapered with her photographs and elicits much enthusiasm and praise from patients.

“Photography is a very important part of my life and everything I do is filtered through my camera lens…I ask, ‘Is this something I want to photograph? How would I fit this into my work?’” Dr. Ryan, who brings her Canon 10D along to neurology meetings, took photographs of old South Beach art deco facades while at a conference in Miami and summed up, “It is very rewarding to attach this aesthetic dimension to daily life.”

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JUAN E. BAHAMON-DUSSAN: PHOTOGRAPHING BIRDS

Juan E. Bahamon-Dussan, MD, a nature photographer, whose works can be seen online at www.birdsofcorpuschristi.com, practices neurology at Corpus Christi, TX – named “America's Birdiest City” in 2004 by the Audubon Society. He specializes in the daunting task of photographing hummingbirds. “Neurology can be emotionally draining…delivering bad news all day and managing chronic diseases that have no cures. Photography provides me with the opportunity to go outside and relax while waiting to get the right shot.”

His group practice setting allows him to frequently leave the office by 5 p.m. in time for the “sweet light” sought by photographers. He regularly sets out for the shore in search of birds, often waiting watchfully in a blind (small tent) in order not to frighten his subjects.

Dr. Bahamon, who won first prize for his photograph of a bald eagle in Wild Bird magazine in 2004, often travels to Central and South America in search of the most colorful birds, at times accompanied by family members.

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ANTHONY C. BREUER: PAINTING AND MEDICINE

Anthony C. Breuer, MD, a neurologist practicing in a group of 12 in Greenville, NC, went back to school 12 years ago and now has a Master of Fine Arts degree. He divides his time between his professional art studio and practicing medicine. Dr. Breuer, who works primarily with acrylic and oil on canvas, said, “Years of experimenting and exploring the unseeable in molecular biology, and of using knowledge of science and astrophysics, has influenced my art.”

“Art is a great relief from neurology, but it is curiously complicated. And so at times, neurology is also a great relief from the art,” Dr. Breuer, said. Dr. Breuer, who displays his art in juried shows regularly, describes his work as conceptual, semi-abstract, and grounded in the nature of reality, energy and matter, space, and time.

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ARANI BOSE AND STEVEN PACIA: ART GALLERY OWNERS

Arani Bose, MD, and Steven Pacia, MD, met during neurology residency at Yale University. They both ultimately completed fellowships at New York University, where Dr. Pacia is currently Associate Professor in Neurology and Director of the Clinical Neurophysiology Fellowship, and Dr. Bose practices as an interventional neuroradiologist. They shared a common interest in contemporary Indian art and, after many trips to India, decided to open an art gallery to feature avant-garde contributions of artists from South Asia.

Their galley, Bose Pacia, which has its own Web site, www.bosepacia.com, was established in 1994 and has held over 30 exhibitions. “Although we have a full-time gallery director, I spend most nights and weekends working with artists and their collections,” Dr. Pacia said. “In a sense, it is a relief from the reigns of medicine, to deal with art and something more esoteric than neurology.”

As with the musicians who have pursued their art, the two worlds often merge. Drs. Bose and Pacia have taken care of artists medically and have patients with an interest in art who frequent their gallery.

Drs. Lederman and Charness performed with other neurologist-musicians at the AAN Annual Meetings from1992 to 2000. Until their funding was withdrawn, the number of participants grew each year and, at its peak, there were about 18 neurologists performing including members of the jazz group, The Oligoclonal Band.

Others have attained gratification from working in a professional community remote from the field of medicine. Said Dr. Ryan: “Photography is a natural conduit to supportive fellow enthusiasts who connect me to a realm of experience beyond the boundaries of daily neurology practice.”

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STROKE

A POEM BY ARTHUR H. GINSBERG, MD:

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comes down, white as an avalanche,

erasing the playground of speech,

piles up in a drift at the tip

of Veida's tongue. She cannot repeat,

no ifs, ands, or buts, calls a comb,

bone, pen, cow. Frustration bleeds

through her brokeness, shudders in

chaotic clutching of spindly fingers,

as if, the right word could be plucked

from air. Veida, Veida, listen to me.

Follow my hand with your eyes. Eyes

brimming, she nods and follows, pendulum

on command. Stroke pitches camp,

lays rebar, pours cement. She grows to

know me and I, her, without ancestral

gift; small patch of brain, ordered as

the stars. From bedside, touch speaks,

vision flows in syllables, unfettered as

a child skipping rope. Fingertips vibrate

loquaciously as lips, extolling all the hope

of eighty-five years; married to darling Jack,

librarian, re-building spines of orphaned books.

Stroke binds her in the vault of our audacious

builder, pitiless as, buried alive. I visit Veida

each day, stunned by peals of laughter at

her own infirmity, that come from cosmic space,

roiling up through ghostly cracks to pry open,

the lock. Waylaid by walls, eyes fade, no word

to frame, good-bye. Undoing speaks to

the marvel of design, more eloquent

than speech, the vespers of silence.

©2005 American Academy of Neurology